Early Support Guide To Key Worker Training[1]

Early Support guide to key
worker training

Early Support guide to key worker training

Contents
Acknowledgments ....................................................................................................... 2
Section 1: Introduction ................................................................................................ 3
Purpose of guide ..................................................................................................... 3
Defining key working ............................................................................................... 4
Rationale for key working ........................................................................................ 4
Key worker functions ............................................................................................... 5
Key workers and the developing pattern of service provision ................................. 6
Implications for training – summary......................................................................... 7
Section 2: Knowledge and skills needed..................................................................... 9
Research evidence.................................................................................................. 9
Organisational standards......................................................................................... 9
Practice standards................................................................................................. 10
Assessment, planning and review ......................................................................... 10
Implications for training – summary....................................................................... 11
Section 3: Providing key worker training ................................................................... 12
Research evidence................................................................................................ 12
Features important for a successful programme ................................................... 12
Learning from the experience of others................................................................. 14
Ensuring a positive future ...................................................................................... 16
Implications for training – summary....................................................................... 17
References................................................................................................................ 19
Appendix 1: Organisations providing training............................................................ 21
Appendix 2: Key worker awareness training – half-day workshop ............................ 22
Appendix 3: Key Worker Training – 2½ day programme .......................................... 23
Appendix 4: Key worker training programme for designated and non-designated key
workers...................................................................................................................... 25
Appendix 4 (continued): Examples of ongoing training............................................. 26
Appendix 5: Examples of organisations offering courses on specialist subjects ...... 27

Early Support 2006 1


Acknowledgments
This guide has been written in partnership with Care Co-ordination Network UK; the
author is Dr Judith Cavet, an independent consultant and researcher. We would like
to thank Miranda Parrott and Gillian Cowdell who worked on an earlier version of the
guide and gathered information from services about relevant training materials and
their use. We are very grateful to the staff of the projects who contributed information
for the guide. In particular, we would like to acknowledge the cooperation of SNIP in
Edinburgh, the Devon Children and Young Peoples Services, Joint Agency Teams
for Children with Special Needs and NCH Pembrokeshire Children’s Centre for
allowing us to present examples of their training materials in the appendices. Finally
we wish to note our appreciation of Tricia Sloper, Professor of Children’s Health
Care, Social Policy Research Unit, University of York who has provided her
expertise, enthusiasm and support throughout the process of preparing this guide.



Section 1: Introduction
Purpose of guide
This guide is designed to be read by those responsible for providing training to key
workers for disabled children and their families. It is intended to be useful to strategic
and operational managers responsible for arranging the provision of key worker
training in their locality and to those who present some or all of the elements of such
programmes. The guide aims to:-

• Introduce the concept of key working
• Indicate the knowledge, skills and qualities needed by key workers
• Present what is known about how relevant training might be provided.

The guide comprises three main sections. Each section ends with a summary of the
implications for training of the information set out within that section. The guide’s
format is as follows:

1 Introduction:
• Purpose of guide
• Defining key working
• Rationale for key working
• Key worker functions
• Key workers and the developing pattern of service provision
• Implications for training – summary.

2 Knowledge and skills needed:
• Research evidence
• Organisational standards
• Practice standards
• Assessment planning and review

3 Providing key worker training:
• Research evidence
• Features important for a successful programme
• Learning from the experience of others
• Ensuring a positive future

The guide is informed by policy guidance and research, as well as national standards
developed to establish best practice in key worker services. It has also drawn on the
experience of a number of professionals who have already made efforts to make
available key worker training. The authors wish to acknowledge and thank those who
have contributed information.

The guide aims to set out briefly the most salient information. Additional information
is available in a chapter (Cavet, forthcoming) prepared as part of a distance learning
course, which is being developed by Early Support (see www.earlysupport.org.uk).
For economy of style, the words "child" and "children" are used in the guide to
include young people.



Defining key working
The term ’key working’ is used in this document to indicate a service which provides
care coordination for disabled children and their families, when the families require
specialist input from multiple agencies. The Care Co-ordination Network UK
(CCNUK), an organisation with responsibility for promoting high standards in key
working in the UK, defines key working as:
“a service, involving two or more agencies, that provides disabled
children and young people and their families with a system whereby
services from different agencies are co-ordinated. It encompasses
individual tailoring of services based on assessment of need, inter-
agency collaboration at strategic and practice levels, and a named
key worker for the child and family." (CCNUK, 2004).

This definition makes it clear that what is meant by the term ’key working’, used in
this sense, is a situation when a key worker is employed in a formal scheme and has
agreed status as a family’s named worker. Some workers, who operate in this way
and are therefore key workers, may be known by other titles, including ’link worker’
and ’family support worker’.

Key workers can be deployed in one of two different ways. They may operate as:

A ’non-designated’ key worker, in which case they provide a key
worker service to some families, while undertaking the
professional role for which they are primarily employed.
A ’designated’ key worker, when they are employed and paid
specifically to carry out the key worker role.

A recent study of key worker schemes in England and Wales revealed considerable
variation in significant aspects of their organisation and the scope of their work
(Greco et al, 2005). The variability in the characteristics of key worker services has
implications for training. For example, one way in which schemes differed was in
regard to the age range of the children who could be considered for eligibility for
their service. Some schemes were directed towards younger children only, while
others worked with children until their transition to adult services.

However, the aims and functions of key worker services remain essentially similar.
CCNUK describes the key worker as:

“A source of support for disabled children and young people and
their families.”
“A link by which other services are accessed and used
effectively.” (CCNUK, 2004).

Rationale for key working
Key worker services have been developed in an effort to overcome some of the
barriers faced by families with disabled children. There is research evidence,
collected over a lengthy period, which demonstrates that families frequently report
that they face an uphill struggle in finding out about and accessing the services they
need. The complexity of the pattern of service provision presents a major obstacle,
which may result in their having to repeat information to a range of professionals in
different agencies. Key working schemes were, therefore, developed to coordinate
the services available to families with disabled children with complex needs.



Where key working schemes have been set up there is research evidence of positive
outcomes for families using them. The most recent survey of key worker services in
the UK reported that:
“Key workers provided a valuable service for families and had positive
impacts on many families’ lives. Key workers’ collaborative work with
other agencies and professionals and with schools facilitated access
to appropriate support for disabled children and their families." (Greco
et al, 2005).

Earlier research (eg Townsley et al, 2004) and evaluations of individual schemes (eg
Barton and Clark, 2005) also suggest similar favourable outcomes for families. In
addition, benefits for staff employed in key worker schemes have been reported,
even though the resourcing and organisation of services were not without problems.
Improved staff satisfaction for those acting as key workers is a frequent gain when
key working schemes are established (Liabo et al, 2001; Townsley et al, 2004; Greco
et al, 2005; Barton and Clark, 2005).

Government policy in England, Scotland and Wales has responded to evidence
about the utility of key worker services by requiring their development for children
with complex needs who require two or more ongoing specialist services. One
significant example of these policy initiatives is the duty, placed by the National
Service Framework for Children (Standard 8), on English local authorities, primary
care trusts and NHS trusts to ensure that:
" Families caring for a disabled child with high levels of need have a
key worker/care manager to oversee and manage the delivery of
services from all agencies involved in the care and support of the child
and family, and to ensure that the family has access to appropriate
services." (Department of Health, 2004).

Key worker functions
The key worker role is summarised by CCNUK as:

• “Providing information
• Identifying and addressing the needs of all family members
• Providing emotional and practical support as required
• Assisting families in their dealings with agencies and acting as an
advocate if required.” (CCNUK, 2004).

Research demonstrates positive outcomes for families result when key workers carry
out the following tasks:

“Providing information and advice to families about services and
support available, both locally and nationally, and how to access
these.
Coordinating care and working across agencies, including
supporting families with regard to care planning and review
meetings.
Improving access to services.
Identifying and addressing the needs of all family members.
Speaking on behalf of the family when dealing with services.
Providing emotional support.
Providing help and support in a crisis.



Providing information specific to the child's condition where
needed.” (Sloper et al, 2006, quoted in Mukherjee et al, 2006).

Key workers and the developing pattern of service provision
The policy shift which now specifically requires the provision of key worker services
is one aspect of policy developments which emphasise the need for a coordinated
package of services to be made available to service users at the point of delivery. In
England this overall thrust is set out in the Every Child Matters: Change for Children
programme (ECM) and made law by the Children Act 2004, which provides the
legislative framework for the ECM. The Children Act 2004, places a duty on local
authorities to promote cooperation between agencies and other appropriate bodies,
and on key partners to take part in cooperation arrangements. Key worker schemes
are one manifestation of this general shift towards an increased focus on interagency
collaboration. Those employed in key worker schemes will need to understand this
context of continuing change and how they will be expected to operate within the
changed system.

The ECM sees integrated working as a key component in the move to coordinated
services for children:
"Integrated working means practitioners [are] enabled and
encouraged to work together in more integrated frontline services,
built around the needs of children and young people, using common
processes and tools which are developed to create and underpin joint
working." (Department for Education and Skills, 2006a).

New processes and tools associated with integrated working include information
sharing guidance, a common assessment framework (CAF) and the introduction of
lead professionals. These innovations are being introduced to staff with the aid of
centrally developed training materials (see
www.everychildmatters.gov.uk/deliveringservices/integratedworking/)

The introduction of the concept of the lead professional is particularly pertinent to
key workers, since the tasks ascribed to both roles share much in common. The
functions of the lead professional are to:

“Act as a single point of contact for the child or family, who they
can trust and who can engage them in making choices, navigating
their way through the system and effecting change.
Co-ordinate the delivery of the actions agreed by the
practitioners involved, to ensure that children and families
receive an effective service which is regularly reviewed. These
actions will be based on the outcome of the assessment and
recorded in a plan.
Reduce overlapping and inconsistency in the services
received." (Department for Education and Skills, 2006b).

It is the role of both lead professionals and key workers to coordinate services, but
the key workers’ role is to work in a more in-depth capacity with families who have
children with the most complex needs (Eagle, 2005). Where a key worker is in place
for the family of a child with complex impairments or health needs they will act as
lead professionals (Department for Education and Skills, 2006b). Policy guidance
has produced the diagram below which represents how a spectrum of support is to
be made available to children with differing levels of need.



The diagram showing the spectrum of lead professional support, below, illustrates
where the key worker role fits in to the overall pattern of service provision for
children. Staff undertaking the key worker role will need to be clear about the
arrangements in place for children and families who no longer are eligible for a key
worker service. Their training will need to include information about how a smooth
transition to other services is to be accomplished.

In recent years there has been a considerable focus on the need to co-ordinate
services for children from ages 0-3 years (Department of Health and Department for
Education and Skills, 2003). The Early Support programme which was set up to
promote the implementation of this policy has helped to develop key working for this
age group and is being extended to children up to the age of five years. Key workers
for these pre-school children will need to be clear about how service co-ordination
for families will be provided when the children approach school age.

Key workers employed in schemes which offer a service to children and young
people until their transition to adult services will need training to ensure they are
familiar with the transition arrangements. Key workers for children of all ages will
need information about how service coordination is to be achieved for those children
and young people whose needs diminish so that they no longer qualify for a key
worker service.

I = Identification and action
T = Transition
N = Needs met

Spectrum of lead professional support (Department for Education and Skills,
2006c)

Implications for training – summary
When being introduced to the concept of key working, staff will need to understand:
What is meant by key working.



The difference between designated and non-designated workers.
Key working can improve outcomes for families.
Key working can lead to greater staff satisfaction.
Key working is required by government policy.
Which key worker functions improve outcomes for families.
Key working is part of a more general change to interagency cooperation.
Key workers act as lead professionals for children with complex impairment and
for their families.
How transition to appropriate services is to be achieved for children who no
longer qualify for a key working service because of their age or changes in their
level of need.



Section 2: Knowledge and skills needed
Research evidence
Key working is a complex and challenging role which requires a good deal of
knowledge and skill. There is research evidence that shows parents do not believe
that it is important for key workers to have a specific professional background.
However, they are clear about the basic skills and qualities required:

“Good communication and listening skills.
Ability to empathise with families, build rapport and develop
relationships of trust with families and other professionals.
Respect for parents and children’s expertise about their own lives.
Ability to ‘stand back and step outside’ one particular discipline.
Negotiating skills and diplomacy.
Ability to see the whole family.
Team working skills.
Knowledge of the roles of other agencies, how other agencies
work and what is available locally and nationally.
Ability to find information and to admit that they don’t know all the
answers.
Time management skills, ability to plan effectively and be a good
organiser.
A good understanding of disability issues.” (Mukherjee et al,
2006).

In the light of evidence from research, CCNUK has developed a set of standards
which well functioning key worker schemes must achieve. These are set out under
three headings:

• Organisational standards
• Practice standards
• Assessment, planning and review.

For the purposes of this guide, the CCNUK standards have been used as the basis
for the development of a detailed list of the knowledge and skills necessary for key
working. These are set out below. The expertise outlined will be required by key
workers in order that the services, within which they work, achieve the necessary
service quality.

Organisational standards
In respect to the service in which they work, key workers need to know:

The nature of the multiagency commitment to the service, both at a
strategic and at a practical level.
The nature of the multiagency management group.
The referral system and eligibility criteria for the service.



The multiagency protocol for joint assessment, including the process for
producing interagency care plans and for reviewing the needs of the
disabled child and their family.
The joint policy for information sharing between agencies.
The communications strategy for the service and how they and service
users are to be involved in planning and developing the service.
Who is to manage the service on a day-to-day basis and report to the
management group.
What resources are available for running the service, including
administrative support and arrangements for training and supervision.
Job descriptions relevant to themselves and colleagues.
Links with other agencies which impact on the lives of disabled children.
The cultural needs of the local population and their implications for
practice.
Systems for monitoring, reviewing and evaluating the service.
For non-designated workers – how their job descriptions are to be
adjusted and how they are to be allocated protected time for their key
worker role.

Practice standards
Key workers need to understand:

The need for proactive, regular contact.
The importance of a supportive, open relationship based on respect for
the views of parents and children.
The importance of a family-centred (not only a child-centred) approach
What different agencies offer and how to go about gaining access to
them.
How to work with families’ strengths, act as an advocate and enable
parents and children to gain advocacy support when required.
Arrangements for training, supervision and peer support.
The location and nature of an information resource covering local,
regional and national services and information about different conditions
and impairments.
How to ensure families have information available which is accurate,
accessible, timely and appropriate.

Assessment, planning and review
Key workers will need to be familiar with and understand:

Interagency assessment processes and how they lead to an interagency
care plan and link with any other assessments undertaken.
The agreed system for interagency care planning reviews and how to time
these according to family preference.
The need to support the preferences of parents and children regarding
assessment and review meetings.
How to ensure appropriate support for children and young people to
participate in their assessment and review, including children who do not
communicate by speech.
Appropriate support for parents to participate in the assessment and
review process.



How to facilitate the participation of families from minority ethnic groups in
assessment and review.
The agreed system for record-keeping, including parents and/or young
person held records.

Research indicates that the key worker role is multifaceted and requires a
complex mixture of knowledge, skills and qualities.
Training is needed about organisational issues.
Training is needed about practice issues.
Training is needed about assessment, planning and review procedures.



Section 3: Providing key worker training
Research evidence
The required content of key workers’ training has been summarised as:

“Disability awareness training.
Childcare legislation and policies relating to disabled children and
key working.
Child protection.
For non-designated key workers, differences between the key
working role and their professional role.
Roles and working of different agencies.
Local services and how to access these. An information pack
about local services and resources should be produced to support
this training.
Communication and listening skills.
Direct work with children, including training on communication with
children who do not use speech.
Family-centred working and advocacy.
Team working skills.
Negotiation and chairing skills.
Time management skills.
Recording systems for key workers.
The system used for multiagency care planning and review.”
(Mukherjee et al, 2006).

This list reflects the findings of recent research, and should inform a programme of
training, which begins with induction and is followed by the provision of regular,
continuing opportunities for staff development and learning.

Features important for a successful programme
Clearly not all of the diverse skills and knowledge needed by key workers can be
addressed at once. Decisions have to be made about which areas of training need
to be prioritised. New key workers will need to learn both about how their local
service will operate and to practise the skills required to facilitate the proper
operation of a key working service. Those preparing staff to undertake this work will
need to develop a programme of training which takes into account their existing
knowledge and skills. A variety of other local factors will also affect the specific
content of the proposed training. For example, the nature of the local scheme, what
other training programmes are being implemented in the area contemporaneously
and the particular characteristics and needs of the local population.

Key worker training should build on the existing strengths of the staff to be trained,
including their prior learning. Although key working is a complex and demanding role,
some key workers will have considerable relevant experience and qualifications. In
an evaluation undertaken by Barton and Clarke (2005) the overwhelming majority of
staff who were about to become key workers "demonstrated a comprehensive array
of expertise." (Barton and Clarke, 2005). The range of skills and knowledge available
varied according to previous professional backgrounds, though many felt they had
insufficient knowledge of the benefit system. It was concluded that "there should be



some appreciation that some professionals will need more training and support than
others." (Barton and Clarke, 2005).

On the other hand, a group of professionals from diverse backgrounds makes
available to a key worker service a broad range of knowledge and skills (Greco et al,
2005). The advantages of the interagency contacts intrinsic to key working were
noted by Townsley et al (2004), who found that working in multiagency services
provided professionals with enhanced opportunities for personal and professional
development. Staff said that working more closely with other professions enabled
them to learn more about each other’s roles and to provide a more efficient service
for families as a result.

However, from the same study it was also clear that, although professionals did learn
from working with each other, targeted training was needed to promote the gaining of
knowledge and skills, relevant to multiagency working.
"It appeared that although learning opportunities were better overall
there was insufficient training on specific aspects of multi-agency
working such as what it meant to be a key worker, how to chair
meetings, and so on." (Townsley et al, 2004).

The absence of the right training resulted in families receiving a service where
professionals were relatively unsuccessful in their multiagency role, such as service
coordination, family advocacy and paying attention to the needs of the child and
family as a whole. Therefore, it is recommended that:
“Multi-agency services for children with complex healthcare needs
should pay attention to the need to provide generic training on
partnership working and what it means for individuals and their
agencies." (Townsley et al, 2004).

The course content of key worker training programmes must include information
about how professionals from different agencies are to work together and how they
can develop the necessary techniques and skills.

In addition, opportunities for the development of knowledge about the roles and
cultures of other professionals should be encouraged by training being carried out in
multiagency groups. The first key principles for the delivery of training about
integrated working are:

“Training to be delivered in a multi-agency setting to help build
networks, understanding of other’s roles and situations and start
to break down professional silos.
Specific activities and time for attendees to get to know each
other are incorporated into each training course to make the most
of the multi-agency opportunity.
Specific activities and time for experiential learning are
incorporated into each training course to provide attendees with
opportunities to test, reflect and discuss the changes to working
practices.” (Department for Education and Skills, 2006d).

Work in Wales indicates the benefits of interagency training in developing:

• “Effective working relationships
• Shared goals and objectives



• Understanding of the roles and responsibilities of different
professions
• Appreciation and respect for agencies values, expertise and
constraints.” (Linck et al, 2002).

Partnership working, both with other professionals and with families, needs to be a
central component of key worker training. Family involvement in training programmes
about key working is essential for similar reasons to those for multiagency training.
Greco et al (2005) note that "parents and disabled young people can play an
important role in training key workers." (Greco et al, 2005).

Full parental involvement in training helps to model and foster working in partnership
with parents in the same way that multiagency training can model working in
partnership with professionals from different agencies. Professionals can learn from
parents – who are conveying their perspective – and from their experience and
knowledge. Parents should be involved in training as recipients of training – for
example, in the case of those parents who are acting as the family’s care
coordinator. Parents should also be involved as trainers themselves, sharing their
expertise with trainees. Importantly, parents should be part of the team responsible
for the development and management of the key working service. This latter role
relates to the fact that parents should be members of the steering group responsible
for the service.

Training at all stages needs to recognise the importance of ’people skills’ which may
be more difficult to acquire than specific knowledge. Parents realise key workers will
not have all the necessary knowledge at their fingertips, and may have to elicit
information on their behalf. However, parents especially appreciate:
“ …listening and communication skills, tact and diplomacy,
approachability, respect for families‘ expertise, and persistence.”
(Greco et al, 2005).

All training should promote a family-centred approach. Particular attention needs to
be paid to ways of raising awareness of the importance of consulting with children
directly with regard to decisions about their own well-being and decisions about the
pattern of service delivery. Key workers are likely to need training in ways of
communicating with disabled children, especially those with cognitive or
communication impairments (Greco et al, 2005). Communication with children,
including children who do not communicate verbally, is now part of the core skills
training programme, developed by the Department for Education and Skills (2005).

Learning from the experience of others
The development of training programmes for key working appears to be much more
established in some services than others (Cowdell and Parrott, 2006). However, it is
possible for those currently developing training to learn from the experience of those
who have already made efforts in this field.

Information elicited by questionnaires from key worker projects established under the
Early Support programme and reported by Cowdell and Parrot (2006), suggests that
key worker training in the nineteen areas in question showed considerable variation
in the stages of development achieved. The amount of resources afforded to training
also appeared to differ markedly among services. Evidence for this was the
considerable variation among the schemes in the number of days spent on induction
training (from 0.5 days to 5 days).



A few schemes had achieved considerable experience, while others had yet to begin
training. Several were taking action to develop programmes. Two more reported that
awareness raising about key working and the role of the lead professional had
resulted from training related to integrated working, which was being carried out in
their area. In one case this training related to CAF and in the other to information
sharing and assessment.

An example of one of the most developed training programmes included the
provision of information about:

• CCNUK key worker standards
• The model of key working to be adopted
• Basic counselling, listening and communication skills
• Respect for families’ expertise
• Advocacy and negotiation skills
• Knowledge about disability
• Knowledge about services
• Time management and planning skills
• Home visiting
• Child protection.

It is evident that programmes were being developed according to local need,
conditions and circumstances. For example, another service had prioritised the
provision of training sessions about statementing, benefits, including Disability Living
Allowance, and MAKATON. The overwhelming majority of schemes involved parents
in delivering training, and several had employed trainers from outside organisations
to contribute to all or part of their programmes (see Appendix 1 for a list of their
names).

At the time of their delivery some training programmes were supported by the
provision of written information for participants. For example, trainers for one
programme developed a Practitioners’ Pack to support key workers. They also sent
out preliminary reading as preparation for the training workshops. This reading
included:

• A short description of the key worker role
• The CCNUK standards
• The relevant chapter from Professional Guidance (Early Support, 2004).

The provision of written material as part of induction training is recommended by
Mukherjee et al (2006).

A useful source of information about how key worker training has been provided to
date is available in the form of induction programmes prepared for key worker
training in the recent past. Appendices 2, 3 and 4 contain brief summaries of three
induction programmes devised in different parts of the UK to lay the foundations for
effective key working. The programmes in Appendices 2 and 4 were initiated by key
worker schemes which work with families with disabled children and young people
up to their transition to adult services. The programme in Appendix 3 was developed
by an independent training provider rather than by staff producing a programme for a
particular key worker service. Appendix 4 also contains brief details about
subsequent training provided to further extend workers’ knowledge base.



These appendices are made available to indicate ways forward which have already
been developed. They are not necessarily reproduced verbatim. Some of them have
been condensed and made accessible to a readership who are unfamiliar with local
conditions and specific models and practices. They are not intended to be regarded
as blueprints, but rather as background information and in an effort to avoid future
training providers having to ’reinvent the wheel’. Where possible, the programmes
are set out in sufficient detail to indicate to readers the methods and pace of training,
as well as the content.

Ensuring a positive future
The relative effectiveness of the programmes outlined above has not been
evaluated, but we do know that a large-scale research study found:
“Key workers who received regular training, supervision and support
were likely to carry out more aspects of key working and had more
positive impacts for families." (Greco et al, 2005).

At the inception of a key worker service, induction training is essential for staff before
they take up their new roles. An induction programme should ensure key workers
fully understand the tasks they are expected to take on for the family, (and those
which they are not), which areas they are responsible for and to whom they are
responsible (Mukherjee et al, 2006).

Following induction, a continuing programme of training, supervision and peer
support will be necessary if a high-quality service is to be provided which meets the
standards developed by CCNUK. An evaluation of key worker schemes in Norfolk
suggested that:
"… all projects existing and in the future, would benefit from:
• More opportunities for formal multi-agency training …
• Increased opportunities for different professional groups to
meet and talk together to enhance inter-professional
understanding and co-operation." (Young and Robinson,
2005).

Young and Robinson point out that it takes time for a group of experienced
professionals from a variety of backgrounds to achieve a shared culture and set of
values, and to become a cohesive, fully functioning team. Opportunities for meetings
with peers and for multiagency training are needed, in addition to support and
supervision (Young and Robinson, 2005).

The role of service manager has an important part to play in the provision of
induction and ongoing training, plus regular, individual supervision and opportunities
for peer support. The manager’s post needs to be sufficiently resourced for these
functions to be carried out.

Training and supervision play an important part in encouraging key workers to reflect
upon their own practice. Key workers also need training and supervision which
encourages them to monitor the overall quality of service provision available to
families. Key workers should be encouraged to participate in internal and external
evaluations of the key worker service and to value communication from families
about its quality. Key workers will be aware that the provision of a key worker service
per se will not overcome resource constraints. They should be trained to document
unmet need so that information can be collated and used to influence future
planning.



The training which has been outlined above needs to be made available as one of
the measures necessary to ensure an optimally functioning key worker service. The
extent of resources available will affect the pace of training; local factors will
influence the specific content of training. However, the overall content required of
training programmes for high quality key working is clear and evidence based.

Greco et al (2005) found that:
“The provision of regular key worker training, supervision focused on
the key worker role, and peer support between key workers strongly
influenced the way in which key workers carried out their role,
including carrying out the different aspects of key working and having
appropriate amounts of contact with families, and thus impacted on
outcomes for families." (Greco et al, 2005).

Staff will vary in the sophistication of their appreciation and grasp of the required
knowledge base and skills, depending on their prior learning and their own aptitude
and skills. Those responsible for the provision of training will need to ensure that
there is initial and ongoing identification of staff learning needs relevant to key
working. Decisions about what training to organise for teams of key workers should
be informed by an awareness of their existing skills and any gaps in their knowledge
base, as well as the need to keep abreast of new developments. Key workers’ views
about priorities for their future training are one indication of what should comprise the
content of future training. Equally important are families’ views about what are
families’ greatest needs in terms of information and service provision.

More advanced and specialised information relevant to key workers who wish to
develop their expertise further is available from a variety of sources. Some
organisations of and for disabled people and their families may offer brief courses on
specialist subjects (see Appendix 5 for some suggestions).

For key workers employed by services for young disabled children, Early Support
have developed five separate training programmes which are aimed at parents,
practitioners and managers. The concept of partnership underlies the different types
of training on offer; contact points are eileen.strevens@rnid.org.uk and
www.earlysupport.org.uk

In addition, some universities and other institutions of higher learning offer
opportunities for extended part-time study on an interdisciplinary basis for staff who
are keen and able to make the necessary commitment. These interdisciplinary
courses offer a broader curriculum than key working alone but afford opportunities
for developing relevant knowledge. The courses are available for students at
different educational levels, as well as from different professional backgrounds.
Some courses have been developed to be available on a distance learning basis and
so can offer opportunities for study to staff from a large geographic area.

Research provides indications of areas of training which can contribute to key
workers’ ability to work to high standards.
Training must be tailored to local conditions, needs and circumstances.
Training should recognise existing staff strengths.
Working in close contact with other professionals promotes useful learning, but
specific training about how to function as a member of a multiagency team is
essential.



Key workers new to the role require training in partnership working.
Training in groups which include staff from different professional backgrounds
and agencies affords a variety of benefits.
Family involvement in key worker training is essential.
Training must include recognition of the importance of ’people skills’.
All training must be family-centred, and should include information about
communicating with children.
Programmes produced by those who have experience of providing training for
key workers offer useful indications about the possible content, pace and
modes of delivery.
Written information provides a useful learning aid to participants undertaking
initial training.
Prior to undertaking key working, staff must be provided with induction training
which clarifies their areas of responsibility.
This initial training should be followed up by a continuing programme of formal,
multiagency training to develop and update workers’ knowledge and skills.
Opportunities for peer support through regular meetings of key worker staff can
help to foster mutual understanding and a shared culture.
The service manager has an important role to play in ensuring the regular
provision of group training and individual supervision which can improve
service quality for families.
Training should encourage key workers to participate in measures which aim to
improve the quality of the service overall.
Once the basic knowledge and skills required for key working have been
acquired, those organising training may wish to commission more advanced
training from organisations with special expertise in areas related to disability
provision.
More prolonged study of an interdisciplinary nature is available on a part-time
basis and/or in the form of distance learning at some UK universities and
colleges.



References
Barton, L. and Clark, L. (2005) “Altogether Now” An Evaluation of the Key Working
Processes in Warwickshire: First Report, Stareton: Warwickshire County Council.

Cowdell, G. and Parrot, M. (2006) Guide to Key Worker Training, unpublished paper,
York: Care Co-ordination Network UK.

Care Co-ordination Network UK (2004) Key Worker Standards, York: Care Co-
ordination Network, available at http://www.ccnuk.org.uk

Cavet, J. (forthcoming) Best Practice in Key Working: What do research and policy
have to say?, Working in Partnership through Early Support, distance learning
programme being developed by Early Support.

Department for Education and Skills (2005), Core of Skills and Knowledge for the
Children's Workforce, Nottingham: Department for Education and Skills Publications,
available at http://www.everychildmatters.gov.uk/deliveringservices/commoncore

Department for Education and Skills (2006a) Introduction to Integrated Working;
Delivery Notes, Nottingham: Department for Education and Skills Publications,
available at http://www.everychildmatters.gov.uk/resources-and-practice/IG00123/

Department for Education and Skills (2006b) The lead professional: Managers’
guide, Nottingham: Department for Education and Skills Publications, available at
http://www.everychildmatters.gov.uk/leadprofeessional

Department for Education and Skills (2006c) Introduction to Lead Professional:
Delivery notes, Nottingham: Department for Education and Skills Publications,
available at http://www.everychildmatters.gov.uk/resources-and-practice/IG00122/

Department for Education and Skills (2006d) Supporting integrated working: Outline
training strategy and plan, Nottingham: Department for Education and Skills
Publications, available at http://www.everychildmatters.gov.uk/iwtraining/

Department for Education and Skills and Department of Health (2003) Together from
the Start – Practical guidance for professionals working with disabled children (birth
to third birthday) and their families, Nottingham: Department for Education and Skills
Publications.

Department of Health (2004) Disabled Child Standard, National Service Framework
for Children, Young People and Maternity Services, London: Department of Health
Publications.

Eagle, M. (2005) Extract from Speech at CCNUK Conference, York: Care Co-
ordination Network, available at http://www.ccnuk.org.uk/

Early Support (2004) Professional guidance, Nottingham: Department for Education
and Skills, available at http://www.earlysupport.org.uk

Greco, V., Sloper, P., Webb, R. and Beecham, J. (2005) An Exploration of Different
Models of Multi-Agency Partnership in Key Worker Services for Disabled Children:
Effectiveness and Costs, Nottingham: Department for Education and Skills.



Liabo, K., Newman, T., Stephens, J. and Lowe, K. (2001) A Review of Key Worker
Systems for Disabled Children and the Development of Information Guides for
Parents, Children and Professionals, Cardiff: Wales Office for Research and
Development National Assembly of Wales.

Linck, P., Elliston, P., Robinson, C., Parry-Jones, B. and Williams, M. (2002)
Partnership Development Framework for Interagency Working, Bangor: Centre for
Social Policy Research and Development, University of Wales.

Mukherjee, S., Sloper, P., Beresford, B., Lund, P. and Greco, V. (2006) A Resource
Pack: Developing a Key Worker Service for Families with a Disabled Child, York:
Social Policy Research Unit, University of York (available from CCNUK, York)

Townsley, R., Abbott, D. and Watson, D. (2004) Making a difference? Exploring the
impact of multi-agency working on disabled children with complex health care needs,
their families and the professionals who support them, Bristol: The Policy Press.

Young, J. and Robinson, J. (2005) An Evaluation of the Norfolk Care Co-ordination
Initiatives, Norwich: University of East Anglia.



Appendix 1: Organisations providing training
1. CCNUK, Tower House, Fishergate, York YO10 4UA. www.ccnuk.org.uk

2. Gollcher Associates, Meanwood House, Rooleymoor Road, Rochdale OL12
7AX. astrid@gollcherassociates.co.uk

3. Early Support, Royal National Institute for Deaf People, 19–23 Featherstone
Street, London EC1Y 8SL. www.earlysupport.org.uk

4. Peter Limbrick, Interconnections, Parks Farm, Clifford, Herefordshire.
www.interconnections.services@virgin.net

5. Special Needs Information Point (SNIP), Royal Hospital for Sick Children, 14
Rillbank Terrace, Edinburgh EH9 1LN. www.snipinfo.org



Appendix 2: Key worker awareness training – half-day
workshop
Devon Children and Young People’s Services, Joint Agency
Teams for Children with special Needs
A PowerPoint® presentation covered:

1. Aims of key worker training – to develop greater knowledge and understanding
of the role of multiagency team (MAT) as established locally and key worker
role.
2. Objectives of key worker training – increased awareness of the key worker
process to equip workers, outline responsibilities, support and available
resources.
3. Every Child Matters – requirement in Green Paper and Children Act 2004 for
single named professionals to lead where children are known to more than one
specialist agency.
4. Key worker definition.
5. Key worker protocols (these indicate possible source of referrals to MAT).
6. Support coordinator role.
7. Children with special needs: process flow chart indicates process from initial
contact to service plan review, including initial assessment, consultation
meeting, appointment of key worker, ’assessment summaries’ and drafting of
integrated assessment and service plan.
8. Initial key worker competences (knowledge of issues facing family, of services
and ability to communicate in person and in writing and build effective
relationships).
9. Initial key worker competences continued (information gathering and analysis,
use of professional judgment, including knowledge of research).
10. Initial key worker competences continued (integrated assessment, service
planning and review).
11. Key worker competences (child protection, practices informed by policy).
12. Key worker competences (teamwork, promotes equality, flexibility, legal
knowledge).
13. Key worker competences (applies knowledge of child development, information
available to MAT, time management).
14. Key worker competences (applies theory, research, IT skills).
15. Evidence of effectiveness of key workers (from research).
16. Key worker tasks (proactive, regular contact with family, ensure implementation
of agreed plan, act as contact point for family and professionals, reviews and
paperwork).
17. Elements of a quality key worker service (proactive regular contact, a
supportive, open relationship, a family-centred approach, working across
agencies, working with families’ strengths and ways of coping, working for
family rather than agency).
18. Criteria for eligibility for service (age range, level of impairment, multiagency
input).
19. Possible responses to initial contact.
20. Content of information pack (which is one potential response to initial contact).
21. Possible decisions resulting from initial contact (and how they should be
recorded).
22. Responsibilities of referral and information coordination.
23. Factors underlining successful key worker services.



Appendix 3: Key Worker Training – 2½ day
programme
SNIP, Edinburgh

Aims of training programme:
To emphasise the importance of developing self-awareness in the role of
care coordinator/key worker.
To identify and promote the development of attitudes and values needed for
effective working in the role.
To identify and promote the development of the skills needed for effective
working.
To stress the need for regular review and reflection of practice.
To encourage ongoing development of skills through identification of further
training needs.

Programme outline:

Session 1 – Setting the context: Care coordination and key working (day
1)

Reviewing the background and development of care coordination at local and
national level.
Defining our terms – establishing a shared understanding of the language of
key working.
Care coordination documentation, recording and sharing information.

Session 2 – Childhood disability, families, society and the key worker
(day 1)

Reviewing the history behind attitudes to disability and childhood.
Exploring our own feelings about disability.
Evidencing of understanding of the social and medical models of disability
and the challenges the key worker faces in working within the social model.
Defining the key worker role and responsibilities and how these differ from
and relate to the usual practitioner role with individuals and families.

Session 3 – The emotional impact of having a child with special needs
(day 2)

Examining stereotypical responses to how families respond to their situation.
Evidencing understanding and awareness of the complicated nature of
individual and collective responses to having a child with special needs.
Identifying the core skills necessary to work with people’s differing responses
and the dynamics between the individuals involved.



Session 4 – Being a key worker (day 2)

Examining the practical implications for families where there is a child with
special needs with regard to the lack of parental control over appointments,
interventions etc.
Evidencing understanding and awareness of the emotional implications with
regard to compliance etc.
Identifying the core skills necessary to effectively coordinate and manage, (in
partnership with families) the practicalities, including when there are issues
around compliance, dispute over suitable treatments etc.
Exploring the role that a contract or agreement can play in defining and
maintaining the role of the key worker.

Session 5 – Supervision, professional development, monitoring and
evaluation (day 3)

Examining the role of supervision and support.
Evidencing an understanding of the need for monitoring and evaluation of
practice as a key worker.
Identifying some possible future training needs.



Appendix 4: Key worker training programme for
designated and non-designated key workers
NCH Pembrokeshire Children’s Centre

Title Time Content
What is a key worker? ½ day Role, time commitment, working across
agencies

Team building 1 day Getting to know you, shared values

Disability equality 1 day Attitudes and practices

A parent’s perspective ½ day Partnership with professionals

Developing a planning ½ day Assessment framework, planning,
system monitoring, reviewing documentation

Information sessions on:
Social care 2 hours Access processes and services

Health 2 hours Services and referral processes

Education 2 hours Statementing and SEN services

Benefits 2 hours Disability benefits

Housing 2 hours Rehousing, adaptations

Leisure 2 hours Specialist and mainstream

Voluntary organisations 2 hours Barnardos, Family Fund



Appendix 4 (continued): Examples of ongoing training

New services
Circles of support
Direct payments
New residential services

New legislation
Carers Act
Disability Discrimination Act

Extra information sessions
Equipment
Disabled facilities grants
Visual impairment
Hearing impairment
Communication with children
Child protection

Types of disability
Autism
Epilepsy
Cerebral palsy
Muscular dystrophy
Down syndrome

Ongoing training held once a month for a two hour session.



Appendix 5: Examples of organisations offering
courses on specialist subjects

1. British Association for Counselling and Psychotherapy, BACP House,
35-37 Albert Street, Rugby, Warwickshire CV21 2SG. www.bacp.co.uk

2. Centre for Parent and Child Support, Munro Centre, Guy’s Hospital, 66
Snowsfields, London SE1 3SS. The centre offers training and consultation in
the Family Partnership Model (formerly the Parent Adviser Model). The model
and associated training aim to help practitioners understand what it really
means to work in partnership with families and to develop the skills of working
collaboratively with them. www.cpcs.org.uk

3. Child Bereavement Trust, Aston House, West Wycombe, High Wycombe,
Buckinghamshire HP14 3AG. www.childbereavement.org.uk

4. Down Syndrome Association, Langdon Down Centre, 2a Langdon Park,
Teddington TW11 9PS. www.downs-syndrome.org.uk

5. National Autistic Society, 393 City Road, London EC1V 1NG.
www.nas.org.uk

6. National Children’s Bureau, 8 Wakley Street, London EC1V 7QE.
www.ncb.org.uk

7. Scope, 6 Market Road, London N7 9PW. A charity which has a course and
information on supporting communication through Alternative and
Augmentative Communication. This is designed for people whose
communication through speech is difficult, or slow to develop. These systems
supplement or support the spoken element in communication. There are
different vocabularies and languages to choose from, so the individual can
use the most appropriate system. 'Supporting Communication through AAC'
is available to download from www.scope.org.uk


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